Blast Injuries are a Unique Form of TBI

Blast InjuriesMild traumatic brain injuries from explosions are common wounds for today’s active U.S. soldiers, affecting an estimated 320,000[1] military personnel serving in Iraq and Afghanistan. Most brain injuries sustained by soldiers are classified as mild traumatic brain injuries, also known as concussions.

Concerns over Persistent Injuries

Col. Geoffrey Ling, a neurologist in the U.S. Army, led the research that concludes there is “a high likelihood that there are some unique features to blast injury.”[2] Blast injuries differ from traditional TBI in that the symptoms last for months rather than just a few weeks. This is particularly alarming since current mild TBI guidelines put troops back on the battlefield weeks after injury. If these soldiers suffer second brain injuries before healing, the results can be permanently disabling or even fatal.

DTI Scans Reveal Ongoing Damage

The evidence of lasting injury appeared in advanced imaging studies on 63 wounded troops. The scans found damage lasting six months to a year following injury. The patients in the study consisted of soldiers returning from Afghanistan and Iraq in 2008 and 2009. Researchers used diffusion tensor imaging (DTI), a special type of MRI particularly good at showing axonal injuries (tears in brain tissue).

Researchers looked at soldiers diagnosed with TBI primarily from blast exposure, but also those who had some other form of blunt head injury. They compared the imaging from these patients with those of other troops who had blast exposure but no TBI diagnosis. The study concluded that 18 of the 63 soldiers already diagnosed with TBI showed excessive abnormalities in their scans. In follow-up scans 6 to 12 months later, 47 patients with TBI diagnoses revealed persisting damage suggesting the injuries were still in the process of healing.

SSpecific Neural Pathways Damagedpecific Neural Pathways Damaged

Not only do blast injuries persist longer, they disrupt neural pathways in parts of the brain not always unaffected in traditional mild TBI cases.  These pathways affect mood regulation, emotions and self-control. This concerns researchers because impulsive troops are dangerous to other soldiers and civilian populations in war-torn countries.

Controversy Regarding TBI Symptoms Remains

Although the scans have helped identify special concerns regarding blast injuries, they cannot resolve the controversy surrounding the origins of TBI symptoms. Researchers still cannot prove whether they come from structural brain injury, disruption to brain chemistry, mental health problems or a combination of them all.

Ongoing research is also needed because this study failed to include any patients who had only primary blast injuries. More studies are needed to compare the scans of those with blast injuries alone to scans of those with blunt head injuries alone.

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